A Multicenter Retrospective Analysis of the Clinical Features of Pernicious Anemia in a Korean Population

송익찬,이효진,김한조,배상병,이규택,양영준,박석영,조도연,김나유,조인성,조덕연 대한의학회 2013 Journal of Korean medical science Vol.28 No.2

To determine the approximate incidence and clinical features of pernicious anemia in a Korean population, we retrospectively analyzed clinical data for patients with pernicious anemia who were diagnosed between 1995 and 2010 at five hospitals in Chungnam province. Ninety-seven patients were enrolled, who accounted for 24% of patients with vitamin B12 deficiency anemia. The approximate annual incidence of pernicious anemia was 0.3 per 100,000. The median age was 66 (range, 32-98) yr, and the male/female ratio was 1.25. Anemia-associated discomfort was the most common symptom (79.4%),followed by gastrointestinal and neurological symptoms (78.4% and 38.1%, respectively). Pancytopenia was found in 36 patients (37.1%), and autoimmune disorders were found in 15 patients (15.5%). Antibody to intrinsic factor was detected in 62 (77.5%) of 80 patients examined, and antibody to parietal cells was detected in 35 (43.2%) of 81 patients examined. Of the 34 patients who underwent tests for Helicobacter pylori, 7 (12.5%) were positive. The anemia-associated and gastrointestinal symptoms resolved completely in all patients after intramuscular injection of cobalamin, whereas neurological symptoms remained in some. In conclusion, pernicious anemia is less frequent in Koreans than in Western populations; however, the clinical features of this disorder in Koreans do not differ from those of Western cases.

Cutaneous plasmacytoma

송익찬,조덕연 대한혈액학회 2012 Blood Research Vol.47 No.3

Diagnostic and Prognostic Implications of Spine Magnetic Resonance Imaging at Diagnosis in Patients with Multiple Myeloma

송익찬,김지나,최윤석,류혜원,이명원,이효진,윤환중,김삼용,권순태,조덕연 대한암학회 2015 Cancer Research and Treatment Vol.47 No.3

Purpose The aim of this study is to determine the diagnostic and prognostic role of baseline spinal magnetic resonance imaging (MRI) in patients with multiple myeloma. Materials and Methods We enrolled patients newly diagnosed with multiple myeloma from 2004-2011 at a single center. Abnormal MRI findings that were not detected in radiographs have been analyzed and categorized as malignant compression fractures or extramedullary plasmacytoma. The bone marrow (BM) infiltration patterns on MRI have been classified into five categories. Results A total of 113 patients with a median age of 65 years (range, 40 to 89 years) were enrolled in the study. Malignant compression fractures not detected in the bone survey were found in 26 patients (23.0%), including three patients (2.6%) with no related symptoms or signs. Extramedullary plasmacytoma was detected in 22 patients (19.5%), including 15 (13.3%) with epidural extension of the tumor. Of these 22 patients, 11 (50.0%) had no relevant symptoms or signs. The presence of malignant compression fractures did not influence overall survival; whereas non-epidural extramedullary plasmacytoma was associated with poor overall survival in the multivariate analysis (hazard ratio, 3.205; 95% confidence interval [CI], 1.430 to 9.845; p=0.042). During the follow-up for a median of 21 months (range, 1 to 91 months), overall survival with the mixed BM infiltrative pattern (median, 24.0 months; 95% CI, 22.9 to 25.1 months) was shorter than those with other patterns (median 56 months; 95% CI, 48.9 to 63.1 months; p=0.030). Conclusion These results indicate that spine MRI at the time of diagnosis is useful for detecting skeletal lesions and predicting the prognosis in patients with multiple myeloma.

The Efficacy and Safety of Platinum/Vinorelbine as More Than Second-Line Chemotherapy for Advanced Non-small Cell Lung Cancer

송익찬,이효진,양영준,최윤석,류혜원,이명원,문지영,조덕연,김삼용,윤환중 대한암학회 2015 Cancer Research and Treatment Vol.47 No.4

Purpose There is no regimen that is strongly recommended for more than second-line treatment. We investigated the efficacy and safety of platinum/vinorelbine as more than second-linetreatment. Materials and MethodsWe selected patients with advanced non-small cell lung cancer (NSCLC) who received treatmentwith platinum/vinorelbine at Chungnam National University Hospital from August2001 to December 2013. The primary end point was the response rate, and secondary endpoints were progression-free survival (PFS), overall survival (OS), and toxicity. ResultsThirty-five patients were enrolled. Response rate was 22.9% (complete response, 0 patients[0%]; partial response, eight patients [22.9%]; stable disease, 10 patients [28.6%]; progressivedisease, 14 patients [40.0%]). A significantly higher response rate was observed forpatients who had responded to previous chemotherapy than for those who did not (34.8%[8/23] vs. 0% [0/12], p=0.020). The median PFS was 4 months (range, 1 to 21 months). Patients with adenocarcinoma and non-smokers had a significantly longer PFS than patientswith non-adenocarcinoma and smokers (5 months vs. 2 months, p=0.007; 4.5 months vs. 2 months, p=0.046, respectively). The median OS was 10 months (range, 1 to 41 months). Patients with good performance status and non-smokers had a significantly longer OS thanpatients with poor performance status and smokers (14 months vs. 4 months, p=0.02;18.5 months vs. 6 months, p=0.049, respectively). The main serious adverse event (grade3 or 4) was neutropenia (15 events, 13.3%) in a total of 113 cycles. ConclusionPlatinum/vinorelbine was effective as more than second-line chemotherapy, and the toxicitywas tolerable, in patients with advanced NSCLC.

여러 내장에 재발한 다발고립형질세포종 1예

송익찬,백승우,진선아,윤각원,양영준,이효진,윤환중,조덕연,김삼용 대한내과학회 2009 대한내과학회 추계학술대회 Vol.2009 No.-

Overview of Thrombosis and Hemostasis System

송익찬 ( Ik-Chan Song ) 대한간학회 2021 간학회 싱글토픽 심포지움 Vol.2021 No.2

증례 : 혈액종양 ; 여러 내장에 재발한 다발고립형질세포종 1예

송익찬 ( Ik Chan Song ),백승우 ( Seung Woo Baek ),이규섭 ( Kyu Seop Lee ),윤각원 ( Gak Won Yun ),양영준 ( Young Jun Yang ),김진만 ( Jin Man Kim ),조덕연 ( Deog Yeon Jo ) 대한내과학회 2011 대한내과학회지 Vol.80 No.5

다발고립형질세포종은 고립형질세포종의 약 5%를 차지하는 매우 드문 질환이다. 저자들은 뼈의 다발고립형질세포 종으로 치료받은 후 완전반응 상태를 유지하던 중, 여러 내장기관에 골수외형질세포종의 형태로 재발한 매우 드문 경우의 다발고립형질세포종을 경험하였다. 뼈의 다발고립형질 세포종으로 치료받은 경력이 있는 68세 남자에서 배뇨곤란 및 변비가 발생하였다. 복부 및 골반의 전산화단층촬영에서 위, 췌장, 골반강 및 우측 둔부에 덩이가 발견되었으며, 위의 덩이에 대한 내시경 조직검사에서 형질세포종이 확인되었다. 이 환자는 내원 20개월 전, 우측 제 6 늑골 및 우측 장골의 다발고립형질세포종으로 방사선 치료를 받았고, 내원 14개월 전에는 좌측 제 5, 6, 7, 9 늑골에 재발하여 방사선 치료를 받았으며, 내원 12개월 전에는 제 5경추에 재발하여 방사선 치료 및 VAD 화학요법을 시행 받은 적이 있었다. 골반강의 덩이에 대한 방사선치료와 bortezomib+dexamethaone 화학요법으로 모든 덩이는 소실되었고, 8개월째 재발의 증거 없이 경과관찰 중이다. 향후 다발고립형질세포종의 임상 경과 및 치료와 예후인자에 관한 연구가 필요할 것으로 생각 된다. Multiple solitary plasmacytoma is a very rare disease entity, which occurs in up to 5% of patients with solitary plasmacytomas. We report an atypical case of multiple solitary plasmacytoma that recurred in multiple visceral organs without any evidence of bone marrow involvement. A 68-year-old male presented with voiding difficulty. Twenty months earlier, he had been placed on local radiotherapy for solitary plasmacytomas in the right 6th rib and right iliac bone. Recurrences were noted 14 and 12 months later in several ribs and the 5th cervical vertebra, respectively. These were well controlled with local radiotherapy and conventional systemic chemotherapy. He had multiple soft tissue masses in the stomach, pancreas, pelvic cavity, and right buttock. An endoscopic biopsy of the gastric mass confirmed the diagnosis of plasmacytoma. Local radiotherapy to the pelvic mass and systemic therapy consisting of bortezomib and dexamethasone were given, and he has been well for 8 months.

Multiple cases of pancytopenia by mushroom poisoning

연상훈,송익찬,조덕연,이효진,류혜원,이명원 대한내과학회 2020 대한내과학회 추계학술대회 Vol.2020 No.1

Fecal microbiota transplantation for the treatment of steroid-refractory gut acute GVHD

서원형,송익찬,조덕연,이효진,최윤석,류혜원,이명원,김주석,박재호 대한내과학회 2019 대한내과학회 추계학술대회 Vol.2019 No.1

성인 철결핍빈혈의 약물치료

고정숙,송익찬 대한의사협회 2024 대한의사협회지 Vol.67 No.1

Background: Iron deficiency anemia (IDA) is among the five greatest causes of disability globally. It can have various causes and may develop concurrently with other health issues. Recently, there have been advances in the treatment of IDA associated with various comorbidities. Current Concepts: The causes of IDA include chronic blood loss, inadequate iron absorption, and increased iron demand. Oral iron supplements are primarily recommended for the treatment of IDA. In cases where oral supplements are ineffective or cannot be used, parenteral iron supplements are administered. Discussion and Conclusion: Identifying the underlying reason for IDA is essential for determining the appropriate and effective treatment plan. In adults, it is important to be aware that gastrointestinal malignancies can be detected as a cause of IDA. Ferrous sulfate tablets are primarily recommended as oral supplements for treating IDA. Among the parenteral iron supplements available in South Korea, both iron sucrose and ferric carboxymaltose can be used relatively safely without significant side effects. Recently, ferric carboxymaltose was reported as being effective for treating iron deficiency associated with heart failure, chronic kidney disease, inflammatory bowel disease, and preoperative IDA.